Thiamine: An indispensable regulator of paediatric neuro-cardiovascular health and diseases

Ysphaneendramallimoggala, Monalisa Biswas, Stanly Elstin Anburaj, Faiza Iqbal, Shrikiran A, Varashree Bolar Suryakanth, Leslie Edward S. Lewis*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

The sustainable developmental goals emphasize good health, reduction in preventable neonatal and under-five mortalities, and attaining zero hunger. However, South Asian countries report a higher incidence of neonatal and under-five mortalities when compared to the Western world, many of which are attributed to maternal and perinatal micronutrient deficiencies. Isolated nutrient deficiency in the absence of calorie deficit poses a diagnostic challenge since such deficiencies present with acute multisystemic and enigmatic manifestations. Thiamine (vitamin B1) is a micronutrient of prime importance which exerts indispensable roles in energy metabolism. Deficiency of thiamine can lead to catastrophic consequences. This review provides insight into the biochemical actions of thiamine in energy metabolism, the compromised aerobic metabolism resulting from thiamine deficiency, and the crucial role of thiamine in the proper functioning of the nervous, cardiovascular, and immune systems. The review also explores the acute life-threatening consequences of thiamine deficiencies in neonates and infants and the speculative role of thiamine in other pathologies like encephalopathy, sepsis, and autism spectrum disorders. However, routine assessment of thiamine in pregnant women and neonates is yet to be implemented, due to the lack of affordable and automated diagnostic techniques, and the cost-intensive nature of mass spectrometry-based quantification. Conclusion: Physicians are recommended to have a low threshold for suspecting thiamine deficiency especially in vulnerable populations. Laboratory diagnosis of thiamine deficiency needs to be implemented as a standard of care, especially in endemic regions. Further, public health policies on food fortification, mandatory supplementation, and surveillance are imperative to eliminate thiamine deficiency-induced health hazards. (Table presented.)

Original languageEnglish
Pages (from-to)4597-4610
Number of pages14
JournalEuropean Journal of Pediatrics
Volume183
Issue number11
DOIs
Publication statusAccepted/In press - 2024

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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